Cardiopulmo Flashcards
Heart sounds: Beginning of ventricular systole
S1
MAP =
DBP + 1/3(SBP-DBP)
Heart sounds: Beginning of ventricular diastole
S2
Heart sounds: Rapid filling of ventricles
S3
Heart sounds: Ventricular gallop
S3
Present 3rd heart sound is indicative of
CHF
Heart sounds: Atrial systole
S4
Heart sounds: Atrial gallop
S4
Present 4th heart sound is indicative of
MI or hypertension
AV node aka
Junctional node
AV valve location
behind tricuspid valve
Tricuspid & mitral valves prevent backflow during what phase of cardiac cycle
Systole
Aortic and pulmonic valves prevent backflow of blood during what phase of cardiac cycle
Diastole
First third of diastole
75% of blood passively flows from atria to ventricles
Last third of diastole
25% of blood; atrial systole
During diastole AV valves are — & SL valves are —-
AV: open
SL: closed
During isovolumic contraction, AV valves are — & SL valves are —-
Both are closed
During period of ejection, AV valves are — & SL valves are —-
SL: Open
AV: Closed
During period of isovolumic relaxation, AV valves are — & SL valves are —-
closed
Phases of systole
Isovolumic contraction
Ejection
Isovolumic relaxation
Afterload of RV
8 mmHg
Afterload of LV
80 mmHg
During period of ejection, first third delivers —% of blood
70%
Normal EDV
120 mL
Normal ESV
50 mL
Normal SV
70-100 mL
Stroke volume =
EDV - ESV
definition of stroke volume
Amount of blood pumped by ventricles PER CONTRACTION
Normal cardiac output
4-6L
P wave
Atrial depo
PQ interval
Beginning of atrial contraction to beginning of ventricular contraction
PR interval: 1st degree heart block
prolonged PR interval
2nd degree Heart Block types
Mobitz type 1 - Wenkebach
Mobitz type 2 - Hay
PR interval - Mobitz type 1
progressive lengthening of PR + drop beats
PR interval - Mobitz type 2
Normal PR interval + drop beats
3rd degree heartblock
mismatch conduction between atria and ventricles
QRS complex
Ventricular depo + Atrial repo
Wide bizarre odd QRS
PVC
Prolonged QRS
Bundle branch block
ST segment
end of ventricular contraction to beginning of ventricular relaxation
Prolonged ST
CHF
Elevated ST
MI
Depressed ST
Myocardial ISCHEMIA
Inverted t-wave
M. ischemia
True MI
ST Segment elevation
increased CK-MB
increased Troponin I
Aggravating factor of pericarditis
trunk movements
relieving factors
kneeling on all 4s
leaning forward
Heart supplied by what segments
C3 to T4
Red flag of CHF
Edema
NYHA Class I METS
6.5 METS
NYHA CLASS 2 METS
4.5 METS
NYHA CLASS 3 METS
3 METS
NYHA CLASS 4 METS
1.5 METS
Braddom Phase 1
acute
inpatient
Braddom phase 1 goal
prevent deformities and complications
Braddom phase 1 exit point
5 METS
Braddom phase 2
convalescent phase
transitional phase
braddom phase 2 goal and activities
goal: promote strong scar formation
activities: walking, bicycling
braddom phase 2 exit point
9 mets
braddom phase 3
training
out patient
braddom phase 3 activities
stretching, plyometrics, calisthenics, aerobics
braddom phase 4
maintenance
most important phase of braddom cardiac rehab
phase 4 - maintenance
Sullivan phase 1 goal
prepare pt for discharge
ECG and vital signs monitoring
Sullivan Level 1
1-1.5 mets
bed
arm support
Sullivan Level 2
1.5 - 2 mets
sit, move legs, transfers
Sullivan Level 3
2-2.5 mets
walk short distance, bathroom privilege
Sullivan Level 4
3.5-3 mets
trunk exercises
Sullivan Level 5
3-4 mets
arm exercises
Sullivan Level 6
4-5 mets
progressive amb
Sullivan phase 2
outpatient
exercise training program
Sullivan Phase 3
Maintenance
Endurance training
risk modification
Location of heart
mediastinum
Age-predicted HRmax =
60-75% (HRmax)
Type 1 alveolar cells
PREDOMINANT alveolar cells, main site for gas exchange
Type 2 alveolar cells
septal cells, surfactant
What fissure/s can be found in the right lung?
Horizontal and oblique fissure
How many bronchopulmonary segments in right lung
10
How many lobes of right lung
3
Fissure of left lung
Oblique
Dorsal respiratory group location
dorsal medulla
Dorsal respiratory group function
inspiration
Ventral respiratory group location
ventrolateral medulla
Ventral respiratory group function
expiration, inspiration
Pneumotaxic area location
upper pons
Pneumotaxic area fxn
turn off inspiration
Apneustic area location
lower pons
apneustic area fxn
turn on inspiration
Central chemoreceptors are located in
medulla
peripheral chemoreceptors are located in
aortic and carotid bodies
Tracheal auscultation & description
over trachea, high pitch
bronchial auscultation & description
over manubrium between two clavicles
high pitch
bronchovesicular auscultation & description
over sternum
medium pitch
vesicular auscultation & description
over peripheral lungs
low pitch
Relaxed inspiration muscles
diaphragm + external intercostals
Forced inspiration muscles
“SUPAS”
SCM
upper traps
pecs major + minor
scalenes
serratus ant and posterior (superior)
forced expiration muscles
abs
serratus post
internal intercostals
continuous breath sounds
wheeze, ronchi
noncontinuous breath sounds
crackles/rales
continuous breath sounds prominent during
expiration
continuous breath sounds caused by
air passing through narrow airways
noncontinuous breath sounds prominent during
inspiration
noncontinuous breath sounds caused by
bubbling secretions
Contralateral shifting seen in
compressive atelectasis (plural effusion)
Pneumothorax
Hemothorax
Ipsilateral shifting
Obstructive atelectasis
Pneumonectomy
Lobectomy
Segmental resection
Diaphragmatic breathing indication
chest breather
improve ventilation
segmental breathing indication
atelectasis
lung surgery
pursed lip breathing indication
copd
prevent airway collapse
Normal Residual volume
1500 mL
Normal ERV
1000 ml
normal tv
500 ml
normal irv
3000 ml
normal IC
3500 ml
normal FRC
2500 ml
Normal VC
4500 ml
COPD shows increase in what lung volumes
TLC
RV
FRC
Acute bronchitis
inflammation of membrane lining of bronchi
Chronic bronchitis area affected
inflammation of bronchi
bronchiectasis
inflammation & DILATION of bronchi
asthma
vasconstriction of bronchioles
Cystic fibrosis aka
mucoviscidosis
cystic fibrosis cause
defect long arm of chromosome 7
destruction of exocrine gland
cystic fibrosis result
mucus clings to airway walls
affected: bronchioles
emphysema
permanent dilation of alveolar wall
emphysema d/t destruction of what protein
elastin
normal ph
7.35 - 7.45
normal pCO2
35-45 mmhg
normal HCO3
22-26 mEq/L
Respiratory acidosis cause
ALVEOLAR
HYPOVENTILATION
Respiratory acidosis early s/sx
DYSPNEA, HA,
RESTLESSNESS,
ANXIETY
Respiratory acidosis late s/sx
CONFUSION
COMA
SOMNOLENCE
Respiratory alkalosis cause
ALVEOLAR
HYPERVENTILATION
Respiratory alkalosis s/sx
STD (syncope, tetany, dizziness) WITH
TINGLING AND
NUMBNESS
metabolic acidosis cause
“DARS”
DM, ALCOHOL,
RENAL FAILURE,
STARVATION
metabolic acidosis s/sx
KUSSMAUL BREATHING (air hunger)*,
NAUSEA/VOMITTING, CARDIAC ARYTHMIAS,
LETHARGY/COMA
metabolic alkalosis cause
EXCESSIVE
INTAKE,
BICARBONATE
IONS, DIURETICS,
STEROIDS,
VOMITING
metabolic alkalosis s/sx
VAGUE SX:
MUSCLE
WEAKNESS
EARLY TETANY
MENTAL
DULLNESS
Postural drainage: bed flat
Upper anterior (supine)
Lower superior (prone)
Upper right posterior lobe (1/4 turn from prone on L)
Middle lobe postural drainage
1/4 turn from supine, T-pos’n
Upper posterior lobes Postural drainage
1/4 turn from prone
Left = reverse T
right = flat
Middle lobe + lingula postural drainage
1/4 turn from supine, T-pos’n
Lower lobes postural drainage
All T-pos’n except superior
